^ Burd, Nicholas A.; Yang, Yifan; Moore, Daniel R.; Tang, Jason E.; Tarnopolsky, Mark A.; Phillips, Stuart M. (2012). "Greater stimulation of myofibrillar protein synthesis with ingestion of whey protein isolate v. Micellar casein at rest and after resistance exercise in elderly men". British Journal of Nutrition. 108 (6): 958–62. doi:10.1017/S0007114511006271. PMID 22289570.
Contrary to certain rumors that animal-based protein is more suitable to trigger muscle growth than plant-based protein, a study by Mangano et al. (2017) could not provide any evidence for this. In contrast, if combined properly, plant-based protein can even have a higher biological quality. A combination of one part wheat protein (e.g. seitan) and two parts soy protein (e.g. tofu) has thus been favored by many bodybuilders. Some bodybuilders, such as Patrik Baboumian and Robert Cheeke, follow a strict vegan diet.
Carbohydrates play an important role for bodybuilders. They give the body energy to deal with the rigors of training and recovery. Carbohydrates also promote secretion of insulin, a hormone enabling cells to get the glucose they need. Insulin also carries amino acids into cells and promotes protein synthesis. Insulin has steroid-like effects in terms of muscle gains. It is impossible to promote protein synthesis without the existence of insulin, which means that without ingesting carbohydrates or protein—which also induces the release of insulin—it is impossible to add muscle mass. Bodybuilders seek out low-glycemic polysaccharides and other slowly digesting carbohydrates, which release energy in a more stable fashion than high-glycemic sugars and starches. This is important as high-glycemic carbohydrates cause a sharp insulin response, which places the body in a state where it is likely to store additional food energy as fat. However, bodybuilders frequently do ingest some quickly digesting sugars (often in form of pure dextrose or maltodextrin) just before, during, and/or just after a workout. This may help to replenish glycogen stored within the muscle, and to stimulate muscle protein synthesis.
Some bodybuilders use drugs such as anabolic steroids and precursor substances such as prohormones to increase muscle hypertrophy. Anabolic steroids cause hypertrophy of both types (I and II) of muscle fibers, likely caused by an increased synthesis of muscle proteins. They also provoke undesired side effects including hepatotoxicity, gynecomastia, acne, the early onset of male pattern baldness and a decline in the body's own testosterone production, which can cause testicular atrophy. Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH), which can cause acromegaly.
In the last week leading up to a contest, bodybuilders usually decrease their consumption of water, sodium, and carbohydrates, the former two to alter how water is retained by the body and the latter to reduce glycogen in the muscle. The day before the show, water is removed from the diet, and diuretics may be introduced, while carbohydrate loading is undertaken to increase the size of the muscles through replenishment of their glycogen. The goal is to maximize leanness and increase the visibility of veins, or "vascularity". The muscular definition and vascularity are further enhanced immediately before appearing on stage by darkening the skin through tanning products and applying oils to the skin to increase shine. Some competitors will eat sugar-rich foods to increase the visibility of their veins. A final step, called "pumping", consists in performing exercises with light weights or other kinds of low resistance (for instance two athletes can "pump" each other by holding a towel and pulling in turn), just before the contest, to fill the muscles with blood and further increase their size and density.
The winner of the annual IFBB Mr. Olympia contest is generally recognized as the world's top male professional bodybuilder. Since 1950, the NABBA Universe Championships have been considered the top amateur bodybuilding contests, with notable winners such as Reg Park, Lee Priest, Steve Reeves, and Arnold Schwarzenegger. Winners generally go on to become professional athletes.